Ideas (Innovation and adoption)

A web based solution addressing some major pain points for Health and Social Care - Cost Savings, visibility of available beds, A&E congestion, Delayed transfer of Care (DToC). We also provide a single Command & Control Centre for Major Incidents

Overview of Innovation:

Our web solution offers:Real-time visibility of available beds: For all care Professionala across multiple care domains and a wide geographical area, including Hosoitals, Trusts, Boroughs and event Social Care block bookd beds. A search for any bed type across across any care domain in a city, region or entire country yields results in a matter of seconds.

A&E:: Visibility of volumes waiting in A&E, their individual waiting times/times to breach and the ability to Triage score each and every one of them. From this, A&E departments can at least make informed decisions and prioritise well in advance of any bed availability issues.

Early warning system: Thresholds maybe set by hospital management, particularly around A&E, Emergency and Acute bed types. These thresholds are then monitored in real-time by our solution, without any additional user intervention. An algorithm we created takes these thresholds and compares them with existing bed levels in order to provide an overall, colour coded hospital status indicator in line with the recent OPEL standard (NHS England 2016). This status indicator also provides colour coded status for each of these key bed types. Simply put it is an early warning system available for every care professional in the hospital setting so that they can all see where pressures are quietly building and take a more proactive approach to hospital status before a crisis occurs.

Outside the hospital: To assist those in search of available beds, such as bed managers from other hospitals, GP’s and other care professional, our solution also provides a high-level view of a hospital’s current status to this wider audience. This approach makes clear whether a hospital or hospitals are currently experiencing difficulties and thus reduce the chance of blindly picking up the phone or making e-mail enquiries on available beds to a hospital that is already struggling.

DToC: Identifies DToC the moment they occur and offers a collaborative approach for both Health and Social Care to manage and reduce DToC via a single interface, We provide full cost and delay duration/impact stats in realtime too, thus removing the overhead from the individual.

Major Incidents: Our Command & Control Centre feature allows co-ordination of multiple A&E's across an entire city via a single interface.

Our feature rich solution does much more.

Stage of Development:

Evaluation stage - Representative model or prototype system developed and can be effectively evaluated

WMAHSN priorities and themes addressed:

Digital health / Innovation and adoption

Benefit to NHS:

A&E congestion and waiting times: Just a 10% reduction in A&E breaches means that around 33,000 patients, per year, would wait less time to receive the appropriate level of care.

Delayed Discharge: A mere 5% reduction in DToC 'Bed Blocking' means a £45m per year saving for NHS alone. That's a reduction of 78,000 delay days; meaning that 6000 more people could receive treatment with the same bed count and less effort. The reduction in managing and reporting overheads for both Health and Social Care are also significant.

Efficiency: Precious time spent on day to day administration for both Heath and Social Care is enormous. Entry of the same information over and over again, manually counting available beds in times of crisis, bed managers glued to the telephone dealing with inquiries and multiple sitrep meetings, each slowly grinding care professionals into the ground. In these areas NHS and Social Care could realise a 90% reduction in effort/time. In a potulation of 200 GP's and 200 bed Managers that equates to circa £8m year on year. GP's couuld locate an approapraite 'available' bed for their patient in seconds without a single e-mail or phone call. Social Care would be able to locate and Block booked bed or Care home bed anywhere in the country in seconds

Command & Control Centre: I the event of a Major Incident - A single Command & Control enables NHS to manage/co-ordinate multiple hopsital locations from a single interface and direct Ambulance Servcies more efficiently.

Initial Review Rating4.20 (1 ratings)

Benefit to WM population:

A&E congestion and waiting times: Just a 10% reduction in A&E breaches means that around 33,000 patients, per year, would wait less time to receive the appropriate level of care.

Delayed Discharge: A mere 5% reduction means a £45m per year saving for NHS. That's a reduction of 78,000 delay days; meaning that 6000 more people could receive treatment with the same bed count and less effort.

Current and planned activity:

We are trying to gain traction with both NHS and Social Care which is notoriously difficult. Our planned activity is to engage with a number of key hospitals and boroughs to showcse our solution. This is the area where we require support in securing the inital contacts and interst in NHS/Social Care.

What is the intellectual property status of your innovation?:

We have the intellectual property of our solution already secured.

Return on Investment (£ Value):

N/A

Return on Investment (Timescale):

N/A

Ease of scalability:

Simple

Regional Scalability:

By design, a web based application is built to scale and is available via the usual suite of internet browsers.Scaling across West Midlands: expected user footprint is circa 250 'concurrent' users
based on 19 Acute, 6 Mental Health, 1 Ambulance trust/s and 7 Social Care boroughs.

Measures:

Outcome: Greater efficiency within Hospitals:
Measure: Before and after comparison on visibility of available beds - quality and cost/time saving
Measure: Impact upon Patient flow
Measure: Impact upon A&E volumes, breaches and management effort. for time/cost saving.
Measure: Before and after DToC volumes, management and reporting effort on time/cost saving
Measure: Cost/time saving v cost of solution
Measure: feedback on impact of application wrt visiblity and ease of use.
Measure: Patient feedback

Outcome: Greater efficiency for Social Care
Measure: Before and after levels of visibility and availability of block-booked or normal care home beds
Measure: Before and after DToC volumes, management and reporting effort
Measure: Care Professional feedback

Outcome: Patient satisfaction
Measure: A&E waiting times and volumes

Adoption target:

Adoption Target: All Acute, Mental Health and Ambulance Trusts in the region.
Minimum viability: 4 Major hospitals in the region along with corresponding Social Care boroughs.

Reduce bedblocking and improve ward care by enabling ward access to digital data upon admission of personal knowledge of the patient including This Is Me, My Passport and Risk data, and assist with stepdown process and therapy

Overview of Innovation:

ReMe supports dementia, older people, carers and families and accompanies the person across their care journey. ReMe was trialled and co-produced by dom care, care homes and in wards.
A new breed, we’ve christened ReMe ‘Activity Based’ software, to differentiate from care planning. For patient knowledge and the ability to enhance care comes from activities, not data input. By using algorithms to source bespoke internet images, music and videos and define a profile it’s possible to deliver more person-centred care. At ReMe’s core are activity tools that learn about the person, such as reminiscence and cognitive therapy, and enable discovering calming content for acute care strategies. ReMe stores life stories, preferences and interests and connects with a care circle, as well as creating automated activity reports which can be sent to the user's family.
Around this person-centred care core are business tools each care sector’s needs. Therefore, ReMe achieves an ROI by assisting in client acquisition, care assessment, acute care planning, management and paper reduction, activity creation, scheduling and data collation, whilst providing family and admin reporting. With cross care sector data connectivity and real portability, ReMe becomes part of a dementia acute care strategy.
For care in the community, ReMe’s free with premium subscriber services. With self-management, connectivity, entertainment and activities and by generating data, ReMe supports daily care, celebrates a life, strengthens family links and tackles agitation, depression and isolation, becoming a highly-personalised resource and recourse.
ReMe is used currently in the following care sectors.
For dom care, ReMe improves care, client engagement, reports and generates extra revenue through selling extra hours based on a wellbeing and family connected value added service.
For care homes, ReMe helps families engage in the care process, carers use tablets productively, reduces paper and enhances activities, therapy and reporting. ReMe improves care and saves money.
For hospitals, ReMe is a low-cost means to better know the patient; that improves admission, through digital connection to the care home and dom carer providing access to knowledge of the patients’ ‘day before’ care profile. ReMe enhances person centred care, patient wellbeing, reporting and stepdown.
ReMe is easily adopted with no legacy software or training needs.

Stage of Development:

Market ready and adopted - Fully proven, commercially deployable, market ready and already adopted in some areas (in a different region or sector)

ReMe supports improved family visits and overnight stays through the provision of familiar content and entertainment.

Automatic care activities recording, for CQC/admin reporting and research is available.

Evidence of value is shown only by the demand and positive feedback received from care homes, LA’s, hospitals and families nationwide but will be formalised shortly.

ReMe addresses the Next Steps NHS Five Year Forward View; by reducing A&E/GP visits, making patients information available to clinicians; enabling prescribing apps to help people manage their own health, addressing loneliness and aiding carer respite and assisting LA requirements regarding services provision and monitoring.

We’re pioneering this connected care approach in conjunction with SWLCC 5-year strategy, focussing on care quality, safety and cost savings, addressing the defined challenges of avoiding hospital admission, supporting ‘Community services to meet the highest standards and working more closely with primary care, mental health, acute hospital services and social care’. Our participation in the Better Care funded Croydon APA project defines ReMe’s role in the budget shift from hospitals to the integration of health and social care, through the coordination of care. Critically, ReMe addresses recommendations by NICE to focus on person centred and family care support through engaging consumers with a user-friendly product that promotes self-management of illness including long term conditions.

Initial Review Rating4.60 (1 ratings)

Benefit to WM population:

RemindMeCare delivers support for older people and people with dementia, their carers and families and which is portable and usable by their carers, from home to domiciliary, live-in, day care, residential and ward care. ReMe was developed with people in the NHS and trialled in wards and care homes.
ReMe is a new breed we’ve christened ‘Activity Based’ software to differentiate itself from care planning software. For knowledge of the person and the ability to enhance care is derived from activity provision, not from data input.
By providing self-management tools and engaging activities and by generating data, ReMe supports daily care, celebrates a life, strengthens links with family and tackles agitation, depression and isolation. ReMe becomes a daily highly personalised resource and recourse for those people involved in care.
ReMe’s suite of person-centred care algorithm based activity tools enhance care and are the constant core across all care sectors, and continually learn about the person wherever they may be. ReMe’s the only system that offers bespoke reminiscence and cognitive therapy by sourcing images, music and videos that are unique to the user and so enables discovering calming content for acute care strategies. ReMe stores life stories, preferences and interests with carers and a care circle, as well as creating automated activity reports which can be sent to the user's family.
Wrapped around this person-centred care core are business tools that address the needs of each care sector encountered by the person, including those common to all such as CQC reporting and family engagement.
RemindMeCare goes further, achieving an ROI for care businesses and wards by assisting in care assessment, acute care planning, management and paper reduction, activity creation/scheduling/planning and data collation, whilst providing family, admin and regulatory body reporting. With cross care sector data connectivity and real portability, ReMe becomes part of a dementia acute care strategy for whichever care sector at any time is caring for the person. For the ward, ReMe offers access to the vital knowledge of ‘the day before’ care profile of the admitted patient and the benefits that enhanced person centred care can deliver.
Usable on any platform and with encrypted data, ico compliance (G Cloud pending), ReMe has addressed information governance and digital security.
Please view videos (https://www.remindmecare.com/business/ward/ )

Current and planned activity:

ReMeApp: self-management care tools that assist maintain care in the community, improve the ability of carers to deliver bespoke care and connect the person with their care circle and with their community; to reduce resort to GP and A&E through enhanced care circle engagement. Dementia care training is included and partnerships with Dementia Pathfinders and Worcester University will be extended achieve delivery.
ReMeData: Integration with Care Planning systems; ie with patient’s systems (such as CMC) and others as required.ReMeGP: GP Connectivity. Through remote connectivity tools GP’s can remain engaged, be better informed but on a remote basis. The intended result is less resort to disturbing surgery visits. GP connectivity will be release in 2018.
ReMeComm: self-management care tools for those cared for in the community, that match the person cared for with local community activities (A partnership pending with Worcester University, CarersUK, MeetingDem and others.

Coronary Artery Disease (CAD) is the leading cause of death world-wide. HeartFlow’s non-invasive technology, FFRct, has been found to accurately diagnose patients with suspected CAD, avoid unnecessary invasive procedures, and reduce healthcare costs

Overview of Innovation:

The diagnosis and care of patients with suspected coronary artery disease is significantly improved by the use of HeartFlow's FFRct analysis. Our process starts with data from a standard Coronary Computed Tomography Angiography (CCTA). High-quality (64 slice or greater) CT scanner images are sent to HeartFlow.

HeartFlow then creates a personalized, 3D model of each patient’s arteries. Where computational fluid dynamics are used to evaluate blood flow and assess the impact of blockages in the arteries. With this actionable information, clinicians can determine the right course of action for each patient.

While FFRct is still in an early stage of adoption, there are now over 150 publications on the technology. Clinical trials have validated both the diagnostic accuracy and clinical utility. Most recently NICE issued guidance on HeartFlow FFRct, stating "The technology is non-invasive and safe, and has a high level for diagnostic accuracy... may avoid the need for invasive coronary angiography... Based on current evidence using HeartFlow can lead to cost savings of £214 per patient."

CT data is securely (Anonymised CCTA data) and seamlessly sent via our “HeartFlow Connect” once installation is approved by the hospital trust. HeartFlow ensures that the scans and FFRct results and analysis models are acceptable to a sites radiologists / radiographers.

Whilst this is an emerging diagnostic its well positioned to become an integral part of standard patient care for those who are at risk of CAD. As this is a new technique HeartFlow provides training to radiologists, radiographers, cardiologists and support staff. We work closely with each site to provide support and training to help evaluate the technology and as they begin to incorporate FFRct into their clinical practice. [A high level overview of HeartFlow’s training support can be found in the Adoption guide published by NICE. (see attached)]

HeartFlow FFRct users are invited to educational seminars and we are working on establishing a UK users group to help sharing best practice around FFRct’s use.

HeartFlow has received CE mark approval for use in UK/Europe. CCTA image specifications for HeartFlow FFRct analysis; HeartFlow’s CCTA quality requirements are consistent with those of the Royal College of Radiology (RCR), British Society of Cardiovascular Imaging and the Society of Cardiovascular Computed Tomography (SCCT) performance of CCTA guidance document.

Stage of Development:

Market ready and adopted - Fully proven, commercially deployable, market ready and already adopted in some areas (in a different region or sector)

Studies indicate that the application of FFRct may result in a reduction of unnecessary angiographies, improved cath lab efficiency, and reduced waiting lists

By providing both functional and anatomic data, physicians may be able to reduce the need for and waiting times associated with other diagnostic imaging tests

Cost of Care

As demonstrated in the NICE guidance, the use of HeartFlow FFRct can potentially reduce the cost of care. NICE estimates an average savings of £214 per patient. This saving is based on not conducting inappropriate invasive diagnostics.

A Japanese study has indicated that the use of the CCTA-FFRct strategy to select patients for Percutaneous Coronary Intervention (PCI) would result in 32 % lower costs and 19 % fewer cardiac events in 1 year compared to the most commonly used CAG-visual strategies.

“The HeartFlow FFRct Analysis provides a definitive understanding of both anatomical and functional findings, without any additional testing or risk for patients. Application of the HeartFlow FFRct Analysis is likely to transform the quality of care we can provide for patients, ensuring the most accurate diagnosis and the best treatment plan, as well reducing the need for invasive coronary angiography – a procedure not without its risks.”
- Dr. Joseph Mills, Liverpoool Heart and Chest Hospital

Online Discussion Rating6.00 (2 ratings)

Initial Review Rating4.60 (1 ratings)

Benefit to WM population:

As stated in the NICE guidance, the adoption of HeartFlow FFRct in the West Midlands region could improve patient care and outcomes while generating significant savings for the region.

We are looking for additional adoption sites and would be interested in hearing from West Midlands Trusts that would like to take the lead in establishing our UK user group.

Current and planned activity:

HeartFlow is in early conversations with NHS Trusts and commissioners. A handful of early adopting NHS medical centres have begun to provide HeartFlow FFRct for their patients. HeartFlow is engaging with interested physicians at centres with high quality CT capabilities.

UK Sites where Heartflow FFRct is being used:

St. Bartholomew’s Hospital (London)

Liverpool Heart and Chest

Russell Hall Hospital (Dudley, West Midlands)

Freeman Hospital (Newcastle)

HeartFlow is in discussion with other UK site about adoption of FFRct.

Planned / required activity

We are looking for additional adoption sites and would be interested in hearing from Trusts that would like to take the lead in establishing our UK user group

Whilst we have undertaken worldwide studies we are always interested in ongoing evaluation / validation and collaborative developments technically and with clinical pathway integration.

In the future we plan on conducting clinical trials based & focused on specifically the UK population.

What is the intellectual property status of your innovation?:

HeartFlow has established significant intellectual property and has been issued several patents.
HeartFlow received CE IIA mark approval for use in UK/Europe in July 2011. The technology is also ISO 13485 certified.

Return on Investment
Savings have been demonstrated in clinical trials (PLATFORM), third party health economic modelling (NICE guidance, Int’l Journal of Cariology 183 (2015) 173-7), and real world experience at early adopting centres.

NICE recommendations for Heartflow FFRct (February 2017) state: “Using HeartFlow FFRct may lead to cost savings of £214 per patient. By adopting this technology the NHS in England may save a minimum of £9.1 million (annually) by 2022 by avoiding invasive investigation and treatment.

Return on Investment (£ Value):

Very high

Return on Investment (Timescale):

6-12 mon

Ease of scalability:

2

Regional Scalability:

Liverpool Heart and Chest has performed more HeartFlow analyses than any other site. They have demonstrated clinical and economic benefits to incorporating HeartFlow FFRct into their practice. The uptake is due in part to to the strong support from their regional CCG.

Measures:

HeartFlow is seeking to achieve the following outcomes:
- Improved patient care: Reduction in unnecessary invasive angiographies and eventually a reduction in waiting times for those patients that need angiographies
- Reduction in Healthcare Costs: NICE estimates cost savings of 214 GBP per patient. We are working with existing sites to demonstrate real world outcomes.
- Quality of Life: HeartFlow's clinical utility trial, PLATFORM, demonstrated an improvement in quality of life when FFRct was incorporated into patient care pathways. It is likely that this is in part due to the avoidance of unnecessary interventions. To date we have not seen any adverse events from avoiding invasive procedures.

Adoption target:

NICE estimates cost savings of 9.1M GBP annually within five years. To reach this objective approximately 35,000 patients would need to have access to a HeartFlow FFRct analysis.

ScanNav® is a software package that provides support to sonographers during the 20 week fetal anomaly scan. It gives real time feedback to the screener on whether paused images are fit for purpose, and on whether the protocol has been followed. It is a peer review, a checklist with which the sonographer may disagree at any time.

Trained by human experts

Consistent

Objective

Always available

ScanNav:

Supports and assists in the supervision of newly qualified sonographers.

Provides oversight of locum sonographers.

Performs automated, prospective second trimester anomaly scan audit.

Provides real-time support for sonographers.

Newly qualified sonographers ideally need another sonographer in the room to assist with their scanning and with quality control, but peer review is time consuming, disruptive, subjective, and a more senior sonographer can’t be there 100% of the time.

ScanNav® automatically examines each image as soon as the sonographer presses pause.
It determines which (if any) FASP fetal anatomy view it represents. It then assesses fitness for purpose against the FASP criteria, reporting that opinion graphically, and giving the sonographer the option to disagree if they wish.

If the sonographer agrees, then no interaction is necessary.

If the sonographer choses to save the image, ScanNav® adds those criteria to the overall record of the view.

A separate interface allows managers to examine individual scans or aggregate performance against FASP criteria. Over time, as the system observes many scans, statistics on scan completeness and quality are collated and can be presented as an audit report.

The sonographer always retains primacy. ScanNav® acts as a consistent colleague. ScanNav® always allows the sonographer to disagree with it.

Using ScanNav considerably reduces the effort required to provide comprehensive peer review and oversight of sonographers.

With ScanNav, the sonographer has immediate feedback on any paused image, identifying which criteria are present, and an automatic intelligent checklist that keeps track of progress through the scan. At the end of the scan, the user or their supervisor can see exactly what has been saved, and can comment, or take further action to complete the scan, as appropriate.

Supervisors can, at any time, easily see overall statistics on sonographer performance, enabling them to instantly examine any images where

The scan is not complete.

The sonographer has disagreed with ScanNav (ruling in or out criteria).

The sonographer has continued to save images where the view was already complete.

This can help guide training and support. ScanNav fits naturally into the standard workflow to enable time savings. Further efficiency savings are expected to be demonstrated once the initial software rollout start in mid-2017.

It is also hoped that ScanNav will improve outcomes. A retrospective audit at one NHS trust showed that nearly 50% of scans had at least one missing view. There are many reasons why this might legitimately be the case – e.g. high maternal BMI or unhelpful fetal position, but ScanNav helps to ensure that any views missed are done so explicitly, with reasons for the missing view recorded. This has both quality and medico-legal benefits, allowing compliance with protocol and due diligence to be easily and reliably demonstrated.

Initial Review Rating3.67 (3 ratings)

Benefit to WM population:

It is well known there is a continued shortage of sonographers. With recruitment being difficult, training and retaining sonographers to reduce reliance on agency workers is the ideal solution, but this inevitably increases pressure on experienced sonographers.

Experienced staff invest a lot of effort and time when training and supporting newly qualified sonographers. Likewise, locum sonographers may require significant supervision from experienced members of the team - adding to an ever-increasing workload. ScanNav will considerably reduce the time needed to provide this support, increasing capacity and reducing costs.

It is also hoped that ScanNav® will improve outcomes. A retrospective audit at one NHS trust showed that nearly 50% of scans had at least one missing view. There are many reasons why this might legitimately be the case – e.g. high maternal BMI or unhelpful fetal position. ScanNav helps to ensure that any views missed are done so explicitly. The live automatic checklist makes it easy to see if any views are still outstanding, and the software will prompt the sonographer to easily record the reason for any missing views at the end of the scan, eliminating accidentally missed views.

Current and planned activity:

ScanNav has been trained using a team of experienced NHS sonographers and over 370,000 ultrasound images, and tested with 60 professionals across 31 clinical and governance institutions, A prototype has been used at the John Radcliffe in Oxford. A demonstration of the software has been shown to two UK trusts so far, and the sonographers preferred ScanNav to manual peer review.

This demonstration of the software is now available to potential Limited First Release (LFR) partners. We want sites to use the CE marked beta software free of charge to assess utility and report back as part of a post market surveillance exercise.

We would like to work with sites to assess how the software enables them to change practice. As a part of this, we would perform an anonymous analysis of one year’s prior images saved under FASP. A full analysis of the completeness and fitness for purpose would be undertaken, allowing a direct comparison of performance before and after the introduction of ScanNav LFR.

What is the intellectual property status of your innovation?:

IP held by company. Simulator is not applicable to patients. LFR release will hold a medical CE mark.

doDOC streamlines collaboration by bringing people and processes together into a single platform, with end-to-end auditability, saving up to 70% in documentation time.

Overview of Innovation:

Life Science and Academic organizations operate in an extremely document-intensive, highly regulated environment. doDOC support this critical process of producing collaborative, compliant, quality documents within tight deadlines.
Whether working with a few individuals or large geographically diverse teams, doDOC makes the co-authoring, review and approval process less painful and more efficient by ensuring neither document quality nor deadlines are compromised in a integrated platform solution.

Documentation processes are typically managed in silos by multiple software in each working group of individuals leading to errors, duplicated information and delays, wasting billions of working hours every year.

doDOC proposal is simple: a single collaborative platform for the creation of documents with granular control over information processes and a system capable of integrating information from multiple sources avoiding duplication and manual tasks, generating a comprehensive audit trail with measurable effectiveness.

How doDOC does that?
1 – Streamlining collaboration and avoiding typical project miscommunication problems;
2 – Automating workflows, ensuring that the right people is doing the right thing in the right moment;
3 – Changing the writing process from a step by step reality to a concurrent and symbiotic experience;
4 – Bringing automation to technical tasks related with document production that until now undermine productivity;
5 – And since doDOC tracks every single event over the entire project, doDOC provides unique insights to allow managers and team members to track progress and access performance in real-time.

This change in the technology behind the creation of information allows doDOC users to decrease immensely the total time for the execution of their document-based projects.

doDOC is a proven cost effective solution for the document co-authoring, review and approval process, providing an excellent return on investment (20X ROI) with both tangible and intangible benefits.

Key benefits to NHS by the use of doDOC is the streamlining of cooperation among healthcare professionals with impact on the following areas: patients, processes and knowledge.

Improved Patient Care: The complexity of managing patients’ health records requires a cooperative effort that encompasses all of the healthcare professionals involved in their care, each in his/her area of expertise, in order to achieve the best outcomes. doDOC streamlines report generation, focus on the content and decrease the time spent in administrative tasks.

Better Process Efficiency: Another variable mentioned when analyzing the usefulness of working together was improving the process. By employing doDOC, the organization is automating the application of standard operational procedures and ensuring compliance with best practices. This improvement in the processes leads to greater efficiency and to an increase in the quality of the healthcare given to the patients.

Promoting Knowledge: The importance of collaborative work was also noted for facilitating knowledge among professionals, optimizing time and resources. doDOC allows sharing information in a more effective manner. By controlling information across the network, professionals provide knowledge that is securely shared, with improved health being the result.

Initial Review Rating3.80 (2 ratings)

Benefit to WM population:

doDOC will promote greater collaboration between the West Midlands Health Organizations: Universities / Hospitals / Companies have with doDOC a single collaborative and secure platform to create value and generate positive impact for the local population.

Current and planned activity:

doDOC currently works with Top10 Pharmaceutical Companies and world-leading research organizations.
doDOC aims to streamline collaboration across life science and healthcare institutions by simplifying the collaborative effort within document-based projects.

SEEING WHAT OTHERS SEE, AND WHAT THEY EXPERIENCE IN THE PROCESS
Eye Control, Eye Perception, Eye Emotion
Affordable,Intelligent Digital Eyewear

Overview of Innovation:

Eye Hyper Tracking System - Smart Wearable
Viewpointsystem has developed a completely new system to measure and understand human perception through the eyes.
The Eye Hyper Tracking doesn't just capture the line of sight,but also how the person reacts to what is seen. The system in the form of smart lightweight safety rated glasses allows extremely precise measuring of observations and insights coupled with the ability to SHARE what is being seen via REMOTE LIVE STREAMING.

Telemedicine - A health professional can conduct or instruct a procedure with the aid of a precise hands free view.

Training - Any aspect of training can be covered, be it a live event or with the ability to record 'what is seen' it can be then shared, learned from and shown as a unique prespective into the instructor or wearers' viewpoint and preception

Paramedic / 1st Responder - Imagine a world where an expert can see what you are looking at and give you on the spot support. Envisage a paramedic or 1st responder calling in advance to show the recieving hospital the extent or seriousness of a situation

Improving Results - Instructions are often given and confirmed as being understood, communication is key in getting things right first time. With a view of 'how' to carry out a instruction, in certain circumstances a person viewing your first attempt is both supportive and safe.

Reducing Costs - Specialists cannot be everywhere all of the time. With a live streaming function, they are only ever a click away to see what you see, thus reducing the need to travel, rebook appointments, move from place to place.

The system has truely endless possibilites. Having been in the scientific arena for a number of years it is proven to be relaible and very accurate. Our system takes the technology from the lab into the real world, being light, highly mobile and robust it is user friendly, simple and smart.

The revolution in the measurement and interpretation of human perception has truly begun.

Stage of Development:

Market ready and adopted - Fully proven, commercially deployable, market ready and already adopted in some areas (in a different region or sector)

Efficiency - Right 1st time approach to training, supportive and inclusive

Efficiency - Faster turnaround times for paramedics at hospitals

Cost Benefit - Travel of key staff and personnel

Cost Benefit - Training budgets reduced to all areas

Cost Benefit - Specialists can support remotely, no need to always attend sites

Cost Benefit - Abilty to simulate a scenario or situation. Feedback could be given by instructor remotely

Cost Benefit - General hospital infastructure - The system is applicable to services outside of medical arena - IT support, Machinery supplier support, building support.

Initial Review Rating4.20 (1 ratings)

Benefit to WM population:

The system is designed to support all industries with medical being a specific area.
Our system not only enables faster, safer, most cost efficent ways of doing things, it provides an enabler to reduce time and improve effectivness.
Any improvements or cost savings can only help improve patient or colleagues healthcare, reduce waiting lists and improve services. It is also key to ensure the highly trained dedicated staff have every possible piece of equipment to help improve their working life balance and conditions.

Current and planned activity:

Our current status is to engage with all 15 AHSN's in the UK.
Our system was only launched in UK in Sept 2016, and we have only just started to engage with the UK health sector.
We have a number of doctors, paramedics and hospitals trialing our system in Europe, and we have just engaged with a leading surgeon in USA who is keen to try our technology, as he was the first surgeon to use Google Glasses to carry out a live stream procedure.

Our primary intention is to be seen and heard by the NHS. We are keen to visit and demonstrate the system and possibilites first hand, as we are not a concept as we have an actual fully functioning system ready to use.

What is the intellectual property status of your innovation?:

We have IP on certain elements of the system.
Eye tracking is commonly adopted in VR/AR system is various guises.

Aptvision is revolutionary to the radiology sector providing a paperless & cost effective workflow. Designed with radiology experts, practiced in-depth and customised to meet the specific needs of today’s modern & demanding radiology environment.

Overview of Innovation:

Total Radiology Solution including RIS and other innovative solutions has been designed to increase efficiency in hospitals and clinics - not just to store patients’ data. It’s unique innovation can be seen in:

Ability to report on studies from any location without a need of installing dedicated software on individual doctor’s PC.

Much more than a standard RIS, Total Radiology Solution offers:

Fully integrated Web Booking in which patients can book their appointment like a seat on an airplane. From the clinic’s website patients can see which appointments are available for the type of exam they need and book it immediately.

Aptvision’s system automatically provides a call back from a clinic’s Call Centre, to verify the selected appointment and go through safety questions. The operator is prompted by the system to ask the appropriate questions.

This feature has reduced the 40% dropped calls rate to zero and practically eradicated no shows and errors.

Before the appointment, the patient receives a SMS Reminder of their visit and gains access to the Online Consent Form. They can complete it on their phone or computer before their visit day.

On the appointment day, patients can use Online Registration in the clinic using the interactive kiosk or tablet & without the need to stand in a long queue at the reception. They can also monitor their live updated waiting time on dedicated monitors.

The electronic consent form as well as all previous medical history is attached to patient’s record in Total Radiology System leading to completely Paperless Workflow. Once the appointment is completed, patient is informed with an SMS telling them their results are ready and can be viewed in the Online Results portal if this is appropriate.

Voice Recognition to more quickly create medical reports

Scan Audits to improve the quality of the reports and enable sharing of expertise.

Stage of Development:

Market ready and adopted - Fully proven, commercially deployable, market ready and already adopted in some areas (in a different region or sector)

"Aptvision is revolutionary to the radiology sector and is the key to a paperless workflow. It improves daily operations and leads to quicker reporting times and early diagnosis. My experience suggests that Aptvision RIS increases a clinic's efficiency and bottom line from day one and has been the answer to our digital problem in one step."

Prof. Michael MaherConsultant Radiologist, Cork University Hospital
Professor of Radiology, University College Cork

Initial Review Rating5.00 (1 ratings)

Benefit to WM population:

With rapidly increasing demand for diagnostic imaging and hospital and clinics workflow heavily relying on paper and manual duties radiology providers are sometimes unable to cope with that increased demand and provide their diagnostic in efficient and timely manner which can result in patient dissatisfaction and in some cases even lost lives.

Aptvision Total Radiology Solution offers a solution that can revolutionize radiology industry by promoting efficiency and paperless workflow that increases productivity in hospitals and clinic and ultimately benefits patients and their lives.
Our innovative features can benefit patients in numerous manner including:

Quality improvement - Peer review feature that allows anonymous review of radiology reports by random peer. It improves the quality of the reports, enhances share of expertise and allows discussion of interesting cases with experts in anonymous manner. This hugely benefits patients and again helps to save lives

Make use of modern ecommerce technologies to patients

Current and planned activity:

Aptvision has just completed the Serendip programme.

We have applied for late inclusion into supplychain RIS/PACS frameworks.

We are actively engaging with Queen's hospital (BHR hospitals trust). We have presented the system and received a very positive response and we are currently organising a full day workshop with all staff.

We are presenting shortly to Black County Alliance.

We are seeking to work in partnership with an NHS Trust to deliver an early demonstrator for the NHS.

What is the intellectual property status of your innovation?:

Full intellectual property of all applications and solutions is owned by Aptvision Ltd.

“myJobCard” is a mobile Work and Asset Management application which integrates with SAP ERP and come with an inbuilt dynamic form engine.
“myJobCard” brings together best practice from our extensive experience of deploying Mobile Asset Management solutions, incorporates feedback provided by our customers, and leverages latest advancements in mobile technology.

Stage of Development:

Close to market - Prototype near completion and final form may require additional validation/evaluation and all CE marking and regulatory requirements are in place

Increased Productivity
1. Save time needed to convert paper forms to electronic forms.
2. Sending jobs directly to staff and get updates in real time in backend system on job updates.
3. Show history of asset repairs to avoid repeated issues.
Reduce cost
1. Better management of materials required to carry out certain jobs
2. Cost savings from increased productivity
3. Cost savings by reducing IT involvement in form creation process.
Better analytics
1. Optimise working time against the waste through better analytics based on real time and accurate capture of information
2. Better decision making based on accurate and better capture of information.

Initial Review Rating1.80 (1 ratings)

Benefit to WM population:

1. Cost savings of NHS service to public and nation as a whole
2. Assets uptime increased
3. No need to provide information time and again to fil forms. some information auto-populated.

Current and planned activity:

myJobCard has been launched recently in the market and we are looking for pilots/PoC customers.

What is the intellectual property status of your innovation?:

There isn't any IP in the app which can be protected. App is protected through copyright.

Stratification of patients into Risk Groups, even for the same condition, greatly enhances the focus, scalability and agility in response to changing demand. Used to manage people with long term conditions such as COPD, Diabetes, Heart Failure, etc…… as well as supporting early discharge to prevent readmissions.

Population-level Low-Risk Patients (75%): Free for BYO devices (smart or text message) for self-management and education. No remote monitoring but data can be shared with GP systems for access by all clinical stakeholders. Minimum cost to the NHS. Scalability is limitless. Activ8rlives4 Wellness and Food Diary App is available FOC via the App store and Google Play.

Rising Risk Patients (20%): Where there is no smart phone availability or poor IT skills: CliniTouch Vie as below. Where Patients own Smartphone/Tablet and have WiFi: Activ8rlives Lung Health, Diabetes Health and others. Medical monitors could be prescribed on loan initially on early discharge (as one use case) and then transitioned to BYO Smartphones and monitors. Alternatively, they may be stepped-up by prescribing further monitors and data reviewed remotely at greater frequency.

Overall reduction of 9.1% in all COPD admissions - despite the harsh winter of 2013/14, there was an overall reduction in all COPD admissions, easing winter pressure and bed blocking.

Effective in managing re-admissions – number of admissions per head reduced from 3.13 to 1.02 per year (p<0.001). Nurse interventions required to manage patients also reduced, improving caseload management. The benefits were realised across the whole health economy.

Patients are educated and supported to interpret the data to enable improved understanding of their health status.

Prevent unnecessary admissions as patients have access to 24/7 the COPD rapid response team as soon as there is any health deterioration for treatment to prevent unnecessary admission into hospital. The collected data is currently being analysed by Knowsley Respiratory Community Team.

Technology improves patient’s confidence in managing their COPD. For patients who experience frequent infections and disease exacerbation, this can be a lifeline. In Liverpool 90% of participants would recommend to Friends and Family. 60% would be prepared to make a financial contribution of £300 to support costs.

Current and planned activity:

Spirit Healthcare group of companies can now provide one of the most comprehensive range of solutions to support patients of all ages, all IT abilities, all levels of disease severity and across a wide range of disease areas: respiratory, cardiovascular, diabetes and frail elderly.

65m urine specimens analysed annually in the UK breaks down to 250,000 every working day, of which 45,000 will be unreliable. This means 45,000 patients daily who will not be treated for urine-based infections. Peezy Midstream means they can.

Overview of Innovation:

Peezy Midstream can save the NHS £30m in reduced retesting of the most common diagnostic procedure.

It is a simple but innovative device that automatically captures clean-catch urine from men, women and children (from toddler age). It is especially valuable for the elderly and pregnant women for whom accurate urine screening is essential.

The average national mixed growth rate reaches from 0.38% to over 70%; the average is 18% - that's nearly 1 in 5 patients who will not receive accurate right-first-time treatment from their urine specimen.

Peezy Midstream reduces mixed growth rates to 1.5%, which means many more patients will be treated right-first-time, saving the NHS as a whole over £30m in direct retest costs and over £1bn indirectly through saving repeat staff and resource time.

Peezy Midstream captures urine specimens hygienically - it prevents spills and splashing, improving infection control in healthcare settings. It can be held by the tube if help needs to be given - the assistant does not risk becoming soiled either.

Dignity is implicit; easy Peezy is comfortable, quick and removes the need to start-stop-start when giving a midstream urine specimen.

There is no down-side to using Peezy Midstream. It saves lives, saves time and money and reduces unnecessary broad spectrum anitbiotic prescribing. Peezy is poised to make novel cancer urine tests more efficient too.

Each Peezy kit costs just 87p on the NHSSC; use ten for every retest. Available on the NHS Supply Chain and on the UK Drug Tariff - growing in popularity with midwives and care givers to the elderly.

Stage of Development:

Market ready and adopted - Fully proven, commercially deployable, market ready and already adopted in some areas (in a different region or sector)

The Recipe for Workforce Planning is an easy-to-use online tool driven by a dynamic process map.The Recipe is a repository for best practice and facilitates peer support through a discussion forum.

Overview of Innovation:

The Recipe for Workforce Planning is an easy-to-use online tool driven by a dynamic process map; users click on each stage of the process to access resources and view the activities needed to complete that stage. The Recipe is a repository for best practice and facilitates peer support through a discussion forum.

This unique resource is the first of its kind, developed by Health Education England working across the West Midlands, and is being shared for use across Health Education England.

The Recipe process map, created in collaboration with workforce planners across the West Midlands, shows the stages that should be completed in order to create a good workforce plan:

Users can click on a stage to open a Stage Page showing:

Ingredients - documents and resources needed to complete that stage which users can download.

Hints and Tips – any useful advice or intelligence that will support the completion of the stage

The Recipe also includes:

What should I be cooking this month?
Each stage in the Recipe has a date range during which that activity should be completed. Users will be able to see the stages within the Recipe which are currently ‘active’ at the time they visit the site.

Roles and Responsibilities
Each of the activities within a stage has an assigned role e.g. Workforce Planner, Finance Lead. Users will be able to sort and filter the site to view only the stages and activities relevant to their role.

Discussion forum
The Recipe has a discussion area where planners can share ideas and ask questions or queries.

Cookbooks
Users can select their favourite resources from the site (Word, Excel, PDF documents) and download these into a pack, or Cookbook. There are also readymade Cookbooks for particular users and scenarios e.g. Workforce Planning for Beginners, Meeting with the Executive Team, Workforce Planning for Commissioners.

Links and Resources
The resources – or Ingredients – available to users for each stage are added to and updated as new resources become available. However, there may be useful resources, reports, articles or links that are not relevant to a particular stage but may be of interest to workforce planners. These are available on the Links and Resources page that will include an archive of all the resources on the site.

The Recipe also includes a search function and an interactive glossary.

Stage of Development:

Market ready and adopted - Fully proven, commercially deployable, market ready and already adopted in some areas (in a different region or sector)

Provides an easy-to-use online tool driven by a dynamic process map, demonstrating what good workforce planning looks like. This unique resource is the first of its kind and can be used in any clinical or non clinical setting when looking to effectively workforce plan.

Initial Review Rating3.40 (1 ratings)

Benefit to WM population:

Provides an easy-to-use online tool driven by a dynamic process map, demonstrating what good workforce planning looks like. This unique resource is the first of its kind and can be used in any clinical or non clinical setting when looking to effectively workforce plan. This resource was developed by the West Midlands and includes templates and resources which are currently being used across the region.

Current and planned activity:

We have launched this resource nationally and are actively promoting this resource across the West Midlands, incorporating any feedback we receive.

For more information or to access the Recipe for Workforce Planning click here

The problem. Correct handling and storage of drugs and medicines is critical in ensuring that they remain functional and safe to use. Regular monitoring and data capture highlights trends and issues not evident from manual record keeping. Over weekends and during holiday periods readings may not be recorded. Failure of a refrigerator or break in power supply could render contents unusable or remain undetected

EveryWare has developed an intelligent software platform with smart sensors, integrated and modular, in conjunction with clinicians to tackle this major problem. Local devices monitor a range of parameters, including ambient temperature, pressure and humidity; together with refrigeration temperatures at different levels within each unit

Local and remote alerts can be triggered when your own defined rules are breached. Alerts may be visual and audible in a monitored location with users receiving direct notifications via email, SMS and other channels. Data is visualized and accessible on computers, tablets and smartphones

Testimonial
Clinical bodies and Trusts’ guidelines require regular monitoring of critical storage temperatures. Legislation requires that records are kept and this is often a manual task with readings taken at up to 24 hour intervals

Successful trials yielded a wealth of information for pharmacy staff to gain immediate, real time insight into how efficient their refrigerators are and how ambient conditions and working practices affect them. Clinicians benefit from the reduced workload and the availability of high resolution data proves compliance with healthcare guidelines 24/7

Differences between types of refrigerator become evident. Recovery time following prolonged periods of access can expose the contents to raised temperatures for longer; trend data clearly demonstrates the effects of daily routines and identifies opportunities for training that will improve the safe storage and dispensing of critical medicines

EveryWare’s unique modular system means that the unit cost of the sensors is low. All other costs are capped, so no need to worry about data rates and variable costs. Annual cost of the system is a fraction of the cost of the assets or processes being monitored. System is designed from the ground up to be completely user-configurable to suit local and business requirements. Security is paramount; all cloud systems and data are network-isolated, multiple-passkey protected with encrypted communications.

Stage of Development:

Market ready and adopted - Fully proven, commercially deployable, market ready and already adopted in some areas (in a different region or sector)

Compliant drug storage
There is a legislative requirement to store critical medicines within specified parameters. Moreover, it is imperative that safe storage can be demonstrated and that only safe products are used.

Equally, any fault or disruption to the storage infrastructure doesn’t automatically render the products beyond safe use. Smart monitoring, reporting and validation afford peace of mind. Efficacy of the drugs can be evidenced and detect abnormal patterns of behaviour or access issues e.g. refrigerator door left open.

Broad clinical guidelines indicate that regular, period monitoring by technicians will suffice; often once every 24 hours and often not during weekends and holiday periods.

There are several risks with this approach that can render expensive drugs ineffective and worse still, fail to deliver the anticipated results. A power outage in the early hours or over a weekend may be masked by a reinstatement long before working hours. The damage may already be done if excessive temperatures have been realised.

The solution is to introduce smart monitoring with remote data logging and alerts. Continuous, electronic monitoring not only captures specific events 24/7 and raise alarms but provides valuable trend data. Battery backup will buffer mains failure without disruption to the monitoring or connectivity. Real time monitoring has clearly shown systematic issues occur out of working hours and variations within specific refrigerated facilities. Clinical practices will also affect the storage conditions; a feature that is evident from trend data. The effects of prolonged loading and unloading with the refrigerator open shows the impact upon refrigeration temperatures and the extended recovery time to achieve safe storage temperatures when eventually closed. Access to the refrigerators out of prescribed hours may also raise an alert if there is a security concern.

EveryWare has installed local monitoring systems in hospitals and clinical environments that are capable of tracking a range of critical conditions. Not just in refrigeration units but ambient conditions in key locations may be monitored through a common network. Within treatment, theatre, storage or living areas the network of wireless devices can track temperature, relative humidity and pressure along with other factors such as controlled access and refrigeration performance.

In homes EveryWare could be used with ambient and movement sensors to detect risk of hypothermia or falls.

Initial Review Rating4.60 (2 ratings)

Benefit to WM population:

Overall benefits summary
Installations of the system have already demonstrated potential savings in recent trials.

Money saved by GP surgeries and health trusts through proper refrigeration of medicines

Money saved by pharmaceuticals companies through proper refrigeration

Money saved by pharmaceuticals companies by not having to pre-emptively over-produce product to compensate for GP and trust wastage

Quality of patient care increases as a result of cost savings throughout the medicine supply chain

Meets strict legislative requirements ((strict environmental monitoring protocols are now required by CQC.Failure to comply requires drugs be destroyed at very high cost).

Monitor multiple installations and multiple sensors from a single location (Dashboard)

Quality control

Constant monitoring of refrigeration and the ability to react instantly minimises the amount of wastage caused by medicine being spoiled by high temperatures. The unique modular design enables additional sensors to be quickly integrated. Predictive analytics software enables custom ‘rules based’ alerts and monitoring protocols to be easily created and monitored.

Legislation

The easy monitoring of temperatures makes it much easier to comply with the strict legislation imposed by health bodies such as the MHRA and CQC.

GP Surgeries

Surgeries and trusts are able to monitor the temperature of their drugs in the refrigerator and react instantly should parameters be broken.

Patient care

The cost savings made by reducing wastage can be channelled back into the healthcare system, improving overall patient care.

Current Activity
Successful trials have been conducted with SWFT Clinical Services Ltd (a subsidiary of the South Warwickshire NHS Foundation Trust) which yielded a wealth of information for pharmacy staff to gain immediate, real time insight into how efficient their refrigerators are and how ambient conditions and working practices affect them.

Positive actions were taken to improve the effectiveness and avoid potential problems that might have occurred. Clinicians benefit from the reduced workload and the availability of high resolution data proves compliance with healthcare guidelines 24/7.

We have recently entered discussions with GP practice in Norfolk in response to CQC’s strict environmental monitoring requirement for drug storage.

Planned Activity

We would welcome NHS input in our systems design and further development

The i-THRIVE programme aims to improve children and young people’s mental health outcomes by working with 30 sites across the country to implement the THRIVE framework.

Overview of Innovation:

i-THRIVE is national programme of innovation and improvement in child and adolescent mental health. It is an NHS Innovation Accelerator and is currently being implemented in national accelerator sites across the country. It is delivered by supporting localities to implement the THRIVE Framework through their CAMHS transformation and service improvement programmes.

i-THRIVE Community of Practice
More than 30 sites make up the i-THRIVE Community of Practice. The Community of Practice includes organisations that are using the THRIVE framework as the basis of their CAMHS transformation and improvement programmes who then share learning about the implementation of THRIVE and how it can be adopted to fit with their local plans for service redesign. Nearly 25% of the young people in England live within a locality that is a member of the i-THRIVE Community of Practice.

i-THRIVE
i-THRIVE is the implementation of the THRIVE conceptual framework, translating the THRIVE core principles into models of care that fit local contexts. Key to this process is the use of evidence based approaches to implementation.

i-THRIVE supports the provision of services using a whole-system, or place-based, approach to the delivery of child mental health services. This involves taking a population approach to delivery of care; enabling integration across health, care, education and third sectors, and a central focus on delivering improved outcomes for children and young people.

Choice and personalisation of care are core values and these are delivered in part through systematic implementation of shared decision making. To support this, a range of validated measures, tools and educational programmes have been developed by partners and are included in the i-THRIVE Implementation Toolkit, including the CollaboRATE measure, Option Grids and shared decision making training through the i-THRIVE Academy.

i-THRIVE Partnership Organisations
i-THRIVE is delivered through a partnership between the Anna Freud National Centre for Children and Families, the Tavistock and Portman NHS Foundation Trust, the Dartmouth Centre for Healthcare Delivery Science and UCLPartners.

Further Information
Further information about i-THRIVE and examples of successful implementation in sites can be found at http://www.implementingthrive.org/. For the latest news and updates you can also follow us on Twitter: @iTHRIVEinfo.

Stage of Development:

Trial stage - Trial stage to prove that the idea actually works as intended

i-THRIVE and the THRIVE framework have been developed to align with and to support established system transformation and quality improvement methodology. The i-THRIVE model is aligned to emerging tariff payments and is identified within Future in Mind as a suggested model of care.

i-THRIVE encapsulates many of the key strategic requirements for delivering CAMHS over the next few years. The NHS Five Year Forward View emphasises services being person-centered, the importance of early intervention, taking a whole system approach and enabling self-care, all of which are core to the THRIVE framework and in the delivery of i-THRIVE. By supporting sites to deliver i-THRIVE we will be helping them to deliver the changes called for in Future in Mind.

Expected benefits include increased proportion of young people accessing CAMHS with higher proportional improvement in vulnerable groups due to outreach and the location and accessibility of assessment services. There will be increased use of community services, self-care and peer-support networks as a result of effective signposting. We expect to see a reduction in waiting times and increased engagement with services with young people involved in co-designing services, their care and in peer-support networks. Efficiency gains are also expected.

Initial Review Rating4.40 (2 ratings)

Benefit to WM population:

We are currently working with sites in the West Midlands to support them in the delivery of i-THRIVE.

Current and planned activity:

i-THRIVE is currently supporting 30 sites across the country to develop and implement the THRIVE framework as part of their CAMHS transformation plans. The programme is funded by Health Education England, The Health Foundation and the NHS Innovation Accelerator to directly support NHS sites and their partners in local government, education and the third sector, by providing learning and development resources, sharing evidence based tools for implementation, the sharing of good practice and support for evaluation.

Flo-Tone CR is a tool helping patients acquire good Maintenance & Technique in using Pressurised Inhalers, teaching how to Inhale SLOWLY and STEADILY. Inhaler Technique Skills are important and a major theme in BTS, GINA and NICE guidance.

Overview of Innovation:

Flo-Tone MDI (also known as Flo-Tone CR) uses a ‘Positive’ Coaching Whistle to help patients learn to inhale SLOWLY and STEADILY. Whistle Signal is a prompt for the canister to be pressed releasing the medication & the duration of the Whistle helps the professional to coach the patient towards correct use.
Pressurised inhaler mouthpieces come in a variety of shapes, accordingly Flo-Tone was originally produced in ‘Circular’ & ‘Regular’ Models. A new improved Flo-Tone CR now fits all mouthpiece shapes by fitting inside the pMDI mouthpiece. The new design ensures all pMDIs produce a whistle at the same flow rate, helping standardise technique.
Studies have been conducted with the new Flo-Tone to ensure that it delivers the full dose. The first study detailing the development of the improvement & its performance was presented at BTS 2015 & subsequently at DDL26.
Available on prescription, the improved Flo-Tone CR can be used with a pMDI simulator (Trainhaler) for training & with the Patient pMDI. It incorporates a cap so that it can be left in situ on the Inhaler. It also includes a rim on the mouthpiece to help patients get their teeth out of the way of the aerosol spray.
We have tested Flo-Tone CR with a variety of inhaled medications (Flutiform, Clenil, Ventolin, QVAR and Sirdupla) – in each case the respirable dose (ie that part that reaches the lungs) delivered for the medication plus Flo-Tone closely matched that of the device alone & in each case unwanted throat deposition was reduced.•Flo-Tone CR controls the resistance of the pMDI, thereby standardising the flow rate at which
Flo-Tone CR whistles
•Provide inhalation & coordination guidance
•Sounds (20-25 L/min)
•Drug delivery improvement = Therapeutic Improvement
•Less throat deposition – potentially less unwanted Throat Side-Effects
•Better control - less breakthrough – less SABA needed
•Better control – less hospitalisation

There have been many papers published, detailing the misuse of pMDI among patients;
Clement Clarke International have used their expertise to concentrate on this area of products. This
has led to the introduction of the ‘Inhaler Technique Training’ range. Each device is targeted at the
training of inhalation technique, guiding patients to inhale at the correct flow rate for pMDI use.

Inhaler technique errors occur in the hands of patients and healthcare professionals. It has been
demonstrated that the majority of healthcare professionals cannot demonstrate correct inhaler use
to their patients. It is not therefore surprising that patients are mostly unable to demonstrate good
inhaler technique. The consequences are significant; patients take higher doses to compensate for
lack of efficacy from medication lost through poor technique, this results in poorer control,
hospitalisation and increased healthcare costs.

The West Midlands region provides a great opportunity for rapid realisation of the benefits of improved inhaler training from a clinical, economic and patients’ quality of life perspectives.

All the required products and training materials are currently available for instant deployment and would offer significant benefits to those GP practices or secondary care providers willing to challenge existing ineffective training and delivery mechanisms and who would act as either the Regional or National adoption lead.

A comprehensive breakdown of the tools and devices required for a GP practice has been provided in an attached document (Essential Requirements for GP Practice Inhaler Training Kits).

Planned/required activity
As a Manufacturer, Clement Clarke undertakes an extensive R&D program and also undertakes On-Site Clinical Trials with GP Practice & Secondary Care.
However, research and trials support partners would be welcomed to further develop the evidence base demonstrating the benefits of improved staff training with associated patient benefits.
In addition, Health Economic studies would also be welcomed to quantify the medication and admission cost savings that would be achieved. This would supplement the Isle of Wight study and include a wider geographical and ethnic / demographic patient cohort.

What is the intellectual property status of your innovation?:

All intellectual Property for devices and training is held by Clement Clarke International

An engaging educational board game and HTML5 web app to help children with Cystic Fibrosis, and their families, to improve their understanding of the condition and how to manage it.

Overview of Innovation:

The game is designed to help children and families manage Cystic Fibrosis more effectively. Originally created by specialists at Coventry & Warwickshire Partnership NHS Trust to help healthcare professionals develop a more effective relationship with young patients and their families. The game was so effective that Focus Games Ltd was asked to redesign and streamline the game and make it available to a wider audience.

The game is designed for between 2 and 4 individual players (or small teams of players) who compete to move around the board answering CF-related questions and scenarios correctly. The game is very easy to play and doesn’t require a specialist facilitator; anyone can play the game. This makes it ideal for use in the home and at school with family, friends and schoolmates.

Objectives

To help young patients, their families and friends to improve their understanding of Cystic Fibrosis and to manage the condition more effectively.

A patient engagement tool for healthcare specialists to use:

Children with Cystic Fibrosis

Families & friends of CF patients

Schools

Public health awareness

Can be used in:

CF clinics

Other healthcare settings

At home

In school

The board game is very portable, the rules are very simple and specialist facilitation skills are not required so the game can be played by anybody in any setting.

The board game is competitive and accommodates up to 4 individual players, or teams of players. Games last between 45 and 60 minutes.

The HTML5 web app is a simplified version of the board game designed for individuals to use on smartphones, tablets and desktop PCs. However, it can also be used with groups on tablets, screens and interactive whitebboards etc.

Stage of Development:

Evaluation stage - Representative model or prototype system developed and can be effectively evaluated

The original game was developed by Coventry and Warwickshire Partnership NHS Trust and Focus Games Ltd has refined and reworked the game to make it more engaging and more likley to suceed as a commercial product. This process was supported byMidTECH Innovations (NHS Innovations West Midlands).

Benefits to the NHS include:

Increased knowledge of CF not just for the patient but for the whole family and improved engagement with the CF Team - This would help give children and young people a sense of control in managing their condition. Symptoms are recognised by CF patients and parents early and acted upon so infections are treated quickly therefore less time would be spent as in an inpatient making savings on bed space and staffing.

Increased understanding of treatments - Children can express and explore their fears and emotions in a safe place. Play provides the medium to help manage these feelings and therefore promotes resilience

Improved compliance with treatment – Children and young people with CF will often have multiple treatment regimens to follow. The CF game gives an understanding of why particular treatments/medicines need to be adhered to. Compliance would mean improved and less stressful visits for treatments and hospital appointments where children are having to be persuaded to comply with cough swabs/lung function tests etc. This can take up a considerable amount of time for nurses and Doctors both in the Community and the Hospital.

Initial Review Rating3.40 (1 ratings)

Benefit to WM population:

All of the benefits that the game could deliver for the NHS would benefit the WM population. In addition the game has been developed by a WM NHS Trust and as such the publicity and any shared revenue will be focussed on the WM.

Current and planned activity:

The original game was developed by Coventry and Warwickshire Partnership NHS Trust and Focus Games Ltd has refined and reworked the game to make it more engaging and more likley to suceed as a commercial product. This process was supported byMidTECH Innovations (NHS Innovations West Midlands).

The board game has been tested within the NHS and also by members of patient support groups. Feedback has been positive and we now wish to extend the scope of testing to cover a more sophisticated online version of the game and also to manufacture the board game.

What is the intellectual property status of your innovation?:

The IP is owned by Coventry and Warwickshire Partnership NHS Trust, and used by Focus Games Ltd under licence from them.

Return on Investment (£ Value):

medium

Return on Investment (Timescale):

6-12 mon

Ease of scalability:

2

Regional Scalability:

This game is designed to be used anywhere in the UK, and possibly overseas. We have not yet secured the funding to launch the game commercially. However, we have launched many other games that are being used extensively in the UK and overseas so we are confident that the model works.

Measures:

The most practical measure will be the collection of qualitative feedback from users both patients, carers and healthcare professionals. This would include ongoing questions about any changes to lifestyle and treatement adeherence. This being done for many other existing games that we have published. We would also approach independent stakeholders and hope to encourage them to study the efficacy of the game.